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Causes of death in obesity: Relevant increase in cardiovascular but not in all-cancer mortality

  • Ralf Bender
    Correspondence
    Corresponding author. Tel.: +49 221 35685-451; fax: +49 221-35685-891.
    Affiliations
    Institute for Quality and Efficiency in Health Care, Dillenburger Str. 27, Cologne D-51105, Germany
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  • Author Footnotes
    † Present address: Radiation and Environmental Health, World Health Organization, Geneva, Switzerland.
    Hajo Zeeb
    Footnotes
    † Present address: Radiation and Environmental Health, World Health Organization, Geneva, Switzerland.
    Affiliations
    Department of Epidemiology and International Public Health, School of Public Health, University of Bielefeld, Universitätsstr. 25, D-33615 Bielefeld, Germany
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  • Martin Schwarz
    Affiliations
    Department of Gastroenterology, Hepatology and Infectiology, University Clinics, Heinrich-Heine-University of Düsseldorf, Moorenstr. 5, D-40225 Düsseldorf, Germany
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  • Karl-Heinz Jöckel
    Affiliations
    Institute for Medical Informatics, Biometry and Epidemiology, University Clinics of Essen, University Duisburg-Essen, Hufelandstr. 55, D-45122 Essen, Germany
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  • Author Footnotes
    ‡ Deceased August 18, 2002.
    Michael Berger
    Footnotes
    ‡ Deceased August 18, 2002.
    Affiliations
    Department of Metabolic Diseases and Nutrition (WHO-Collaborating Centre for Diabetes), University Clinics, Heinrich-Heine-University of Düsseldorf, Moorenstr. 5, D-40225 Düsseldorf, Germany
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  • Author Footnotes
    † Present address: Radiation and Environmental Health, World Health Organization, Geneva, Switzerland.
    ‡ Deceased August 18, 2002.

      Abstract

      Background and Objective

      To assess the relation between body mass index (BMI) and the risk of death from various causes in a prospective cohort study.

      Methods

      In 6,192 obese patients (BMI ≥25kg/m2) with mean BMI 36.6 kg/m2 (SD 6.1) and mean age 40.4 years (SD 12.9) who had been referred to the obesity clinic of the Heinrich-Heine-University Düsseldorf, Germany, between 1961 and 1994, there were 1,058 deaths from all causes during a median follow-up time of 14.8 years. We calculated standardized mortality ratios (SMRs) with 95% confidence intervals (CIs) for death from predefined groups of diseases by using Germany as reference population.

      Results

      In both sexes, risk of death from cardiovascular diseases (men: SMR = 2.2, CI 1.9–2.5; women: SMR = 1.6, CI 1.5–1.8), from diabetes (men: SMR = 5.4, CI 3.2–8.7; women: SMR = 3.5, CI 2.6–4.8), and in men from digestive diseases (SMR = 1.6, CI 1.01–2.3) was significantly increased. In contrast to other studies, an association between obesity and all-cancer mortality could not be found. Only in morbidly obese women (BMI ≥40 kg/m2), all-cancer mortality was significantly increased (SMR = 1.5, CI 1.1–1.9).

      Conclusion

      Obesity is associated with increased risk of death from cardiovascular diseases and diabetes in both sexes, and from diseases of the digestive system in men.

      Keywords

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